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  Sally McKenzie's
 Weekly Management e-Motivator
  7.18.03 Issue #73

Breaking Down From ‘No Way’ to ‘I Want it Today’

Sally Mckenzie, CMC
McKenzie Management

     Many patients are ill informed about comprehensive dentistry. They require an investment of time and education before they understand the treatment and are ready to make both the emotional investment and the financial commitment. Securing treatment acceptance for major and even minor cases requires three key elements – communicating clearly and listening carefully, involving the patient, and addressing their issues. Here are 10 strategies you can implement today to increase your treatment acceptance.

  • Engage patients in conversation about their oral health goals. This is going to give you invaluable insight into the patient’s perceptions, fears, expectations, concerns, and, most importantly, potential objections to treatment.
  • Ask several broad questions and listen to what your patient is and is not telling you. For example, “How do you feel about your smile?” “How well can you chew with your partial?” “How would you feel if you had all of your teeth?” “How would you like to enjoy a wonderful meal without having to pass on some of your favorite foods or having to worry about pain when you chew?”
  • Use the open questions to get to the heart of what is going to motivate your patient to pursue treatment.
  • Encourage the patient to do most of the talking.

You Have it, They Want it – The information you gather tells you and your treatment coordinator what is going to motivate that patient emotionally. The patient will not proceed with treatment if they do not have an emotional attachment to the benefits. As the exam is the basis for the clinical diagnosis, the question/answer period is the basis for the “emotional assessment,” which is what drives the patient to want the best dentistry you have to offer.

You Understand it, They Don’t – Remember your audience. The more technical and clinical the presentation the more likely the patient is going to feel lost and uncertain about proceeding.

  • Present the case in terms the patient can understand.
  • Avoid clinical references or prematurely using materials that may graphically demonstrate the procedure before the patient is emotionally committed.
  • Use testimonials from other patients who sing your praises and encourage prospective patients to talk to them about the procedure. Nothing will have more impact than the endorsement of another successful patient.
  • Train and involve the entire team in reinforcing the treatment plan with the patient – from the chairside assistant to the front desk.

They Want it, But ...

  • Welcome objections and encourage them. “Do you have any fears or concerns about the treatment?”
  • Avoid the natural tendency to react defensively or feel frustrated. Objections are another means for the patient to gather information and are essential in enabling them to feel confident in their decision to pursue the recommended treatment.

If you have any questions or comments, please email Sally McKenzie at

Interested in having Sally speak to your dental society or study club?
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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos”

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

Professional Communications via email

Last week I discussed professional communications in general using your computer system [see article]. The following is a reader’s request for more detail from last week’s article.

Dear Mark,
I would be interested in understanding the opportunities available to me as a periodontist relating to Email communication strategies and how they could be implemented.

Kindest Regards,
Dr. Inquisitive (periodontist)

Great question!

Specialists and general dentists alike have yet to truly leverage electronic communication. For the sake of this article, I am going to lump web sites, web site hosting, attachments, and individual emails into your question. The concept is centered around creating an electronic patient co-management community. Your electronic community will cement your referral relationship. Sharing patient information will become faster, cheaper, safer, and easier (key) for everyone involved.

What should specialists consider?

  1. Provide bandwidth (cable, DSL, or dialup) and email boxes for the general dentists AND their business administrators! Have your office web site marked in their “favorites” folder of the web browser! Have a form ready for them to fill out when they refer a patient to your office or, create an automatic referral email that is easily created from their end. The keys are “fast” and “simple”.
  2. Provide your business administrator with an email box at work. The relationship between your business administrator and the business administrators at your referring dentists are key (mostly under exploited) relationships to building your referral base. Your business administrator should be able to email requested documents, charts, insurance info, x-rays, digital images, upon request of your referring doctors’ team.
  3. Those individual paper patient reports are nice but look at the overhead on their end. Paper reports take time. Mailing them takes more time. Receiving them, opening them, pulling the chart or placing them on the general dentist’s desk takes even more time. The general dentist needs to review each report - that takes time. What if the reports were sent right after the patient was seen? What if perio charts, x-rays, or digital photos were sent along with the report? Doesn’t that make everything easier for your referral sources? You bet!
  4. I know of a few specialists who have established electronic case studies and e-learning centers on their web site. The area requires secure access to dentists only. Here, you and your referral sources can collaborate on specific cases together.
  5. What if my practice management software doesn’t support emailing clinical information? Well, your practice management software may not but MSWindows does if you know how to do it. For instance, bring up a full perio chart in your practice management system. If you do not have “email” as a command under “File”, simply press the “Prt-Sc” key on your keyboard. Open up MSWord (new document). Right click your mouse. Select the “paste” option. You should have a resizable picture of your chart in the document now. Go to the top of MSWord and select “File”, “Save As”, and name the document. It’s always good to name your documents in the following format (ptlastname _ ptfirstname _ typeofdocument _ date). Smith_Bob_FMChart_7-13-2003 would be an example naming convention.
  6. Before you do any of this, talk to your referring dentists. The next time you take them out for lunch, tell them what you are thinking of doing and see if they get excited about it. Remember to tell them that it will make their life and their business administrator’s life a lot simpler. Tell them it will allow both of you to communicate instantly. Also tell them, it will allow them to review your reports from their computer rather than when they clean up the piles on their desk (usually once a week).
  7. How about an email list of all of the patients you referred back to the general practice for routine maintenance? If your practice management software has a recall list and you can separate it by referring doctor – you have what you need. This will reinforce your instructions to the patients and erode any fear that you are “stealing” maintenance patients.

Chances are your best referring dentists are within a 20 mile radius of your office. Chances are your cable TV company would be delighted to install cable modems and internet access at a reduced rate if you are picking up the tab for eight or ten of your best referring practices. If cable access isn’t available or less than affordable, local dialup access has to be. Once your local dental community is established, your specialty office will be THE referral of choice. You can use technology to eliminate 90% of the headache and overhead of referring out.

Thank you very much for your questions, please keep them coming.

If you have any questions or comments, please email Mark Dilatush at

Interested in having Mark speak to your dental society or study club?
Click here

Getting The Cold Shoulder


Giving Dentists And Their Staff Different Perspectives On Day To Day Issues

From the Coach:

Today’s column is a continuation of the saga of Dr. Desperate and his older brother which began two weeks ago. It is essential that you pay to the universal truths that govern their predicament

and perspectives.

Summary: several weeks ago, I answered a question sent in by Dr. Desperate who was a victim to the female forces of his office. He was defending one female staff member who had a questionable reputation from the other female team members who wanted her to leave the team.

I answered his question in this newsletter [see article]. I then received an email from his older brother who found my answer courageous but expressed his paralysis due to the fear of implementing the suggestions based upon his past experience.

Today’s column introduces additional universal truths about human nature from which a reasonable solution can be found.

As a coach, I do not judge the people; I only judge the situation. I accept the right for the women in the office to determine what they consider morally appropriate and acceptable behavior. In addition, I respect the employer's right to value technical proficiency over moral character.

Truth #4 The universal priority to survive applies to the group (women) first and the individual (doctor) second. The doctor will lose this battle eventually, because the moral high ground has greater appeal to the brain. The women will feel naturally and universally empowered to strengthen their social, political, and economic alliance in their practice and with other practices when they discuss their situation, which they are certain to do. Tension will continue in this office until the employer and the employees discuss the same problem: is a woman who uses illicit means to get what she wants acceptable to this team.

Truth #5 Every day that we go to work, we bring the tools and weapons that we developed in childhood with us. The women in this story are doing what women do all over the world. They are talking and comparing facts and fictions in order to feel less vulnerable. This is reasonable behavior and is universal. Dr. Desperate has chosen to ignore the women’s need for safety and social accountability in the name of his own perhaps unconscious desires. The women will not permit him this latitude, nor would any group of women permit a masculine employer such latitude, except of course if he was the President of the United States. If technical proficiency and personal preferences of the employer are to dominate, then the women will be understandably resentful and will continue to bite at the ankles of the teacher's pet and her defender.

Truth #6, Individual morality is derived from our community morality. You can deny your own truth, but not that of the group you belong to. The doctor is free to deny his own true feelings or insist on having his way; however, if moral character were to be the agreed upon standard of behavior, then perhaps a woman of similar background and values would be more the appropriate solution for everyone.

Truth #7 Defending the honor of someone whose morality is in question and will not defend themselves cannot succeed. It is reasonable to expect the woman who was accused of sexual impropriety to live with the truth of her reputation or she should defend her dignity from false accusations by the other women. It is the lack of initiative to defend herself that permits Dr. Desperate to rise to the occasion and defend her honor. And in so doing, Dr. Desperate has created this problem, because he does not see the issue. He makes the issue a question of proficiency, because that is how he measures his own self worth; however, the person in question is a woman and a member of the staff. There are other considerations that he does not acknowledge.

Truth #8 Men and women do not reason the same with the same data. They will draw identical or different conclusions because of this cognitive fact. Dr. Desperate’s brother admitted that asking all the questions as outlined in my first answer did not appear to him to resolve the issue. In his mind, he visualized the discussion, the appeal to rationality, the passive acceptance, the resentful compliance, and then the reappearance of the problem. Dr. Desperate's brother’s solution to everything is to appeal to the other person’s reason and when agreement is not found, backdown. Dr. Desperate’s brother has brought his childhood experience to work by envisioning his incapacity or the ineffectiveness of his appeals to make an impression on the female alliance. This was his experience in the past, but there is no reason for it to be the assumption of the present. Women do not solve their problems only with rationality. One explanation might be that rationality can be too shortsighted. Women intuitively understand that the greatest rationale of all still doesn't guarantee an equitable solution. Thus, rationality often falls short. Rationality provides a direct line to relieve the individual’s tension, and this is a typical male solution. However, this is not an individual problem. This is a group problem, and it is a mixed gender group problem and thus requires a solution that accounts for everyone's need to feel heard, accepted, and appreciated. Rationality does not accomplish these requirements.

It is Dr. Desperate's brother’s lack of experience with broader male-female solutions that limits his rationality. He consoles himself and his powerlessness by limiting the number of people he interacts with. The answer to Dr. Desperate's brother’s problem is to find new behaviors that provide outcomes that go beyond his childhood history. This is what we do in coaching.

The Coach

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Sally's Mail Bag

Dear Sally,
I am hoping you can assist me in finding a better way of handling our hygiene reminder postcards. Presently, postcards are addressed and mailed out 2 to 3 weeks prior to the patient's appointment. As you can imagine, this is very time consuming. Could you advise me of a simpler and more efficient process. We will have our patients address their own cards and then file them. Now, however, the next problem is 'how do we organize and file these cards', i.e., alphabetically or chronologically. I would appreciate any suggestions or guidelines you could share. Thank you in advance for your help.

Kathy H.
Appointment Coordinator

Dear Kathy,
Have the patient address the card to themselves. This should be asked of by the hygienist and at that time she is explaining the "system" to the patient, i.e., what the card is for, when they are going to get it and what you want them to do when they get it. The cards are filed by the month they are due to return, chronologically. Don't forget when they are mailed to match them with the print out of patients due for the month from the computer. This just happened to me as a patient. My dentist forgot to remind me because they didn't have me fill out a card at my last appointment but if they would have verified it with the computer I would have been caught. Remember "taking too much time" doesn't exist with recall. It is the backbone of the practice.


Missed Past Issues of Our e-Motivator Newsletter?

"Hopefully we can come back to the center and visit soon! I also wanted to brag on our office! Yesterday, my hygiene department produced $2,025 in one day! We were so excited! Just thought I would let you know and thank you for all your advice! Our hygiene department rocks!!*

Alexis, Patient Coordinator
Graduate of The Center for Dental Career Development

*Note: Results are four months after receiving training from The Center

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